The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2015
Transfemoral transcatheter aortic valve insertion-related intraoperative morbidity: Implications of the minimalist approach.
Transfemoral transcatheter aortic valve insertion may be performed in a catheterization laboratory (ie, the minimalist approach). It seems reasonable when considering this approach to avoid it in patients at risk for intraoperative morbidity that would require surgical intervention. We hypothesized that it would be possible to associate baseline characteristics with such morbidity, which would help heart teams select patients for the minimalist approach. ⋯ Patient and valve characteristics are not predictive of significant intraoperative morbidity during transfemoral transcatheter aortic valve insertion. The finding has implications for patient selection for the minimalist approach.
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J. Thorac. Cardiovasc. Surg. · Nov 2015
The influence of a percutaneous mitral repair program on surgical mitral valve volume.
Percutaneous mitral repair with the MitraClip system (Abbott Vascular, Santa Clara, Calif) has been available in trials since 2006 and is currently approved for patients with degenerative mitral valve disease at prohibitive risk for surgery. There has been concern that novel transcatheter approaches may detract from mitral valve surgical volumes. We sought to evaluate the influence of our MitraClip program on our surgical mitral valve volumes and outcomes. ⋯ The availability of MitraClip resulted in an increase in our mitral valve referrals. Despite seeing an increase in higher risk referrals, operative mortality for mitral surgery remained excellent. Multidisciplinary evaluation, including input from experienced mitral surgeons, is necessary to have a successful percutaneous and surgical mitral valve program.